Patriarchal norms and reproductive vulnerability: association between son preference and high-risk fertility behaviour in India

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This research examines the link between son preference and high-risk fertility behaviours in India.
Analyzed nationally representative data from the National Family Health Survey-5 (2019-21) involving 229,680 women aged 15-49 with recent live births.
Employed multivariable logistic regression and Fairlie decomposition to assess disparities and associations.
Defined son preference based on ideal numbers of sons versus daughters and categorized high-risk behaviours.
Women with son preference had 30% higher odds of any high-risk fertility behaviour (AOR = 1.30, 95% CI: 1.27-1.34).
Having three or more daughters resulted in significantly higher odds of high-risk fertility behaviour (AOR = 7.59, 95% CI: 7.26-7.93).
Maternal age of 35 years or older was associated with higher odds of high-risk fertility behaviour (AOR = 5.03).

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Reveals son preference impacts high-risk fertility behaviour in women, suggesting structural changes are needed.

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Barik et al. (2026) studied this question.

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